颈动脉内膜中层厚度与血管内皮功能的相关性

摘要

Objective To observe the correlation between intima-media thickness (IMT) and vascular endothelial function (FMD and NMD) and its relative factors.Methods The patients (n=150) were chosen from Jul. 2012 to Jul. 2013 and then divided, according to IMT degree, into three groups (eachn=50), including group A (IMT<1.0 mm), group B (1.0 mm≤IMT<1.5 mm) without plaques and group C (IMT≥1.5 mm) with intima thickening and plaques. The changes of fasting plasma glucose (FPG), blood fat, creatinine (Cr), high sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), fibrinogen (Fib), FMD and NMD were detected in three groups. The differences in all indexes were analyzed.Results There were no statistical differences in plasma glucose, total cholesterol (TC), low-density lipoprotein (LDL) and Cr among three groups (P>0.05). The average levels of hs-CRP, Hcy and Fib were higher, and FMD and NMD were lower in group B and group C than those in group A (P<0.05). The average levels of hs-CRP and Hcy were higher in group C than those in group B. The levels of hs-CRP, Hcy and Fib were all correlated to IMT (hs-CRP:r=0.459; Hcy:r=0.432; Fib:r=0.485, allP<0.05).Conclusion IMT is closely correlated to vascular endothelial function and levels of hs-CRP, Hcy and Fib.%目的：观察颈动脉内膜中层厚度（IMT）与血管内皮功能包括反应性充血后内径变化率（FMD）、含服硝酸甘油后血管内径变化率（NMD）及相关因子的相关性。方法纳入2012年7月～2013年7月广东省阳江市人民医院体检人群150例，根据颈动脉内膜中层厚度，将患者分为三组，每组50例。A组：IMT＜1.0 mm；B组：1.0 mm≤IMT＜1.5 mm；C组：IMT≥1.5 mm。对入选者行空腹血糖（FPG）、血脂、肌酐、超敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）、纤维蛋白原（Fib）、FMD、NMD检测，统计分析三组患者各项指标的差异。结果三组患者在血糖、胆固醇（TC）、低密度脂蛋白（LDL-C）、肌酐方面比较无统计学差异（P＞0.05）。B、C两组患者hs-CRP、Hcy、Fib均值水平高于A组，FMD、NMD均值水平均低于A组，差异有统计学意义（P＜0.05）。C组患者hs-CRP、Hcy均值水平高于B组，差异有统计学意义（P＜0.05）。hs-CRP（r=0.459，P＜0.05）、Hcy（r=0.432，P＜0.05）和Fib（r=0.485，P＜0.05）均与IMT呈正相关。结论 IMT与内皮功能密切相关，与内皮功能有关的hs-CRP、Hcy、Fib均与IMT正相关。